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Purpose As the COVID-19 pandemic continues, efforts by radiology departments to protect patients and healthcare workers and mitigate disease spread have reduced imaging volumes. This study aims to quantify the pandemic's impact on physician productivity across radiology practice areas as measured by physician work Relative Value Units (wRVUs). Materials and methods All signed diagnostic and procedural radiology reports were curated from January 1st to July 1st of 2019 and 2020. Physician work RVUs were assigned to each study type based on the Medicare Physician Fee Schedule. Utilizing divisional assignments, radiologist schedules were mapped to each report to generate a sum of wRVUs credited to that division for each week. Differential impact on divisions were calculated relative to a matched timeframe in 2019 and a same length pre-pandemic time period in 2020. Results All practice areas saw a substantial decrease in wRVUs from the 2020 pre- to intra-pandemic time period with a mean decrease of 51.5% (range 15.4%–76.9%). The largest declines were in Breast imaging, Musculoskeletal, and Neuroradiology, which had decreases of 76.9%, 75.3%, and 67.5%, respectively. The modalities with the greatest percentage decrease were mammography, MRI, and non-PET nuclear medicine. Conclusion All radiology practice areas and modalities experienced a substantial decrease in wRVUs. The greatest decline was in Breast imaging, Neuroradiology, and Musculoskeletal radiology. Understanding the differential impact of the pandemic on practice areas will help radiology departments prepare for the potential depth and duration of the pandemic by better understanding staffing needs and the financial effects., Highlights • Imaging deferment strategies have been implemented in radiology due to COVID-19. • Deferment strategies have impacted imaging volumes and radiologist productivity. • All practice areas have experienced a decrease in wRVUs. • Breast imaging, Neuroradiology, and MSK radiology experienced the greatest decline.

Rationale and Objectives The COVID-19 pandemic has greatly impacted radiology departments across the country. The pandemic has also disrupted resident education, both due to departmental social distancing efforts and reduced imaging volumes. The purpose of this study was to assess the differential impact the pandemic had on radiology resident imaging volumes by training year and imaging modality. Materials and Methods All signed radiology resident reports were curated during defined prepandemic and intrapandemic time periods. Imaging case volumes were analyzed on a mean per resident basis to quantify absolute and percent change by training level. Change in total volume by imaging modality was also assessed. The number of resident workdays assigned outside the normal reading room was also calculated. Results Overall percent decline in resident imaging interpretation volume from the prepandemic to intrapandemic time period was 62.8%. R1s and R2s had the greatest decline at 87.3% and 64.3%, respectively. Mammography, MRI and nuclear medicine had the greatest decline in resident interpretation volume at 92.0%, 73.2%, and 73.0%, respectively. During the intrapandemic time period, a total of 478 resident days (mean of 14.5 days per resident) were reassigned outside of the radiology reading room. Conclusion The COVID-19 pandemic caused a marked decrease in radiology resident imaging interpretation volume and has had a tremendous impact on resident education. The decrease in case interpretation, as well as in-person teaching has profound implications for resident education. Knowledge of this differential decrease by training level will help residency programs plan for the future.

Risk factors for pulmonary embolism in patients with coronavirus disease 2019 include obesity, an elevated d-dimer value, elevated C-reactive protein level, and a rising d-dimer value over time.

Objective COVID-19 vaccine mandates are being implemented in health systems across the United States and the impact on the radiology department workforce and operations due to vaccine hesitancy among healthcare workers is currently unknown. This article discusses the potential impact of the COVID-19 vaccine mandate on a large multi-center radiology department as well as strategies to mitigate those effects. Methods Weekly vaccine compliance data was obtained for employees across the entire health system from August 17, 2021 through September 13, 2021 and radiology department specific data was extracted. Vaccine compliance data was mapped to specific radiology job titles and the five different hospital locations. Results A total of 6% of radiology department employees were not fully vaccine compliant by the initial deadline of September 10, 2021. Magnetic resonance (MR) technologists and radiology technology assistants had the highest initial rates of non-compliance of 37% and 38%, respectively. Vaccine non-compliance rates by the mandate deadline ranged from 0.5-7.0% at the five hospital sites. Only one hospital required a decrease in imaging hours of operation due to the vaccine mandate. Conclusion Despite initial concerns about the impact of vaccine-mandate non-compliance on departmental operations, there was ultimately little effect due to improved vaccine compliance following the mandate. Understanding individual employee and locoregional differences in vaccine compliance can help leaders proactively develop mitigation strategies to manage this new challenge during the COVID-19 pandemic.

Large vessel occlusion in patients on ECMO is challenging to appreciate clinically secondary to sedation or induced paralysis, thus placing more emphasis on neurovascular imaging. However, emergent CTA and CTP are both inaccurate and unreliable in ECMO patients due to altered circuitry and interference with normal physiologic hemodynamics. In this review, the utility of DSA is discussed in evaluating the altered hemodynamics of VA-ECMO circuits and patency of major vasculature. In addition, the potential use of TCD in ECMO patients is discussed.

Non-neoplastic sinonasal disease is common and imaging often plays an important role in establishing the proper diagnosis, guiding clinical management, and evaluating for complications. Both computed tomography and magnetic resonance imaging are commonly employed in the imaging evaluation and it is important to understand the imaging characteristics of the unique types of pathology affecting the sinonasal cavities. This article reviews a variety of infectious, inflammatory, and other non-neoplastic sinonasal pathologies, highlighting imaging features that aid in their differentiation.